Echinocandins versus amphotericin B against invasive candidiasis in children and neonates: a meta-analysis of randomized controlled trials.

Icon for Elsevier Science Related Articles

Echinocandins versus amphotericin B against invasive candidiasis in children and neonates: a meta-analysis of randomized controlled trials.

Int J Antimicrob Agents. 2019 Mar 01;:

Authors: Chen YH, Cheng IL, Lai CC, Tang HJ

Abstract
OBJECTIVE: This meta-analysis aimed to assess the efficacy and safety of echinocandins in comparison with amphotericin B in treating invasive candidiasis among paediatric patients.
METHODS: PubMed, Embase and Cochrane databases were searched up to August 2018. Only randomized controlled trials (RCTs) evaluating echinocandins and amphotericin B in the treatment of invasive candidiasis among paediatric patients were included. The outcomes were clinical responses and adverse effects.
RESULTS: Five RCTs of 354 patients (191 patients in the echinocandins group and 163 patients in the amphotericin B group) were included in this study. Overall, no significant differences between echinocandins and amphotericin B were found in terms of clinical response (odds ratio (OR), 1.38; 95% CI, 0.68-2.80; I2 = 39%). Similar results were also observed in the high-risk group (OR, 3.10; 95% CI, 0.10-97.23; I2 = 76%), the low-risk group (OR, 1.29; 95% CI, 0.36-4.62; I2 = 21%) and the neutropenia group (OR, 1.56; 95% CI, 0.75-3.26; I2 = 0%). The risk of discontinuing the treatment due to adverse effects was significantly lower in the echinocandins group than in the amphotericin B group (OR, 0.30, 95% CI, 0.12-0.76; I2 = 0%).
CONCLUSIONS: No differences in terms of efficacy were found between echinocandins group and the amphotericin B group in the treatment of invasive candidiasis in paediatric patients. However, the echinocandins group had a significantly lower risk of discontinuing the treatment than the amphotericin B group.

PMID: 30831231 [PubMed - as supplied by publisher]